Revenue Integrity Insider

CMS makes changes to behavioral health, new codes, and cuts to rates in 2025 MPFS final rule

Wednesday, November 6, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

Organizations must prepare for a slew of new codes and billing updates for Part B payment, according to the 2025 Medicare Physician Fee Schedule (MPFS) final rule. The final rule, released November 1, details CMS’ numerous changes to payment rates, billable services, telehealth rules, and other...Read More »

Revenue Integrity Insider

CMS issues PrEP NCD

Wednesday, October 9, 2024
Billing and Claims, Coding and Documentation, Coverage, News

CMS recently issued a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent HIV in high-risk individuals.Read More »

NAHRI Journal - Volume 8, Issue 4

Navigating the 2025 MPFS proposed rule

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.Read More »

NAHRI Journal - Volume 8, Issue 4

Different payment policy rationale in different CMS rules raises serious questions

Wednesday, October 2, 2024
Billing and Claims, Coding and Documentation, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Jugna Shah, MPH, CHRI, highlights the need for Medicare payment policy changes.Read More »

NAHRI Journal - Volume 8, Issue 4

Putting the 2025 OPPS proposed rule under the microscope

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at major changes in the works for outpatient reimbursement.Read More »

NAHRI Journal - Volume 8, Issue 4

Download the October 2024 issue of the NAHRI Journal

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Set the stage for success and close out the year strong.Read More »

NAHRI Journal - Volume 8, Issue 4

2025 IPPS final rule calls for a TEAM effort

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how to ensure your organization is in compliance with CMS’ newest rules.Read More »

Leadership Council Insider

Advocating for change in the 2025 OPPS proposed rule

Friday, September 20, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, NAHRI Leadership Council, News, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI submitted comments to CMS on several key aspects of the calendar year (CY) 2025

...Read More »

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